Fetuin-A levels may predict gestational diabetes mellitus risk

  • Jin C & al.
  • BMJ Open Diabetes Res Care
  • 1 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Plasma fetuin-A levels were higher in both the first and the second trimesters among women with gestational diabetes mellitus (GDM).
  • Dynamic change in plasma fetuin-A levels was associated with changes in insulin resistance and β-cell function from the first to the second trimester, and associated with an increased risk of the development of GDM.

Why this matters

  • Findings indicated that fetuin-A may be an important biomarker involved in the pathogenesis of GDM.

Study design

  • A nested case-control study included 135 women with GDM (cases) and equal number of age- and gestational age-matched women with normal glucose tolerance (controls).
  • All women were categorised into different quartiles (Q1, Q2, Q3 and Q4) according to the distribution of fetuin-A concentration.
  • Funding: National Natural Science Foundation of China.

Key results

  • GDM vs placebo group had a significantly higher plasma fetuin-A concentration during:
    • first (medians, 403.0 vs 273.4 pg/mL) and
    • second trimester (medians, 475.7 vs 290.8 pg/mL; P<.05 for both>
  • In the multivariate analysis, change in fetuin-A concentration from the first to the second trimester was associated with changes in fasting insulin level (β, 0.032; P<.001 homoeostasis model assessment of insulin resistance p and homa function>
  • Compared with lowest quartile, highest quartile of the increase in fetuin-A concentration from the first to the second trimester was associated with a higher risk of developing GDM (OR, 2.14; 95% CI, 1.05-4.37; P=.002).
  • The optimal cut-off value of fetuin-A levels during the first trimester as an indicator for diagnosing GDM was 305.9 pg/mL with a sensitivity of 0.644, specificity of 0.585 and with the area under curve at 0.612 (95% CI, 0.544-0.680).

Limitations

  • Results have limited generalisability.